Roni Breanne Gibbs, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

263902 Issued in KY

Practice address

307 Jason Dr Ste 4
Richmond, KY 40475-2774

Phone

(859) 353-3666

NPI assigned

Jun 9, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Busy Bee Occupational Therapy

  • Occupational Therapist
  • Berea, KY
  • NPI 1487031902
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1053988808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 JASON DR STE 4",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752774",
            "telephone_number": "859-353-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 JASON DR STE 4",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752774",
            "telephone_number": "859-353-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "RONI",
        "middle_name": "BREANNE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2022-02-24",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "263902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genoa Healthcare LLC
• Nicholas George, DPT
• Geraldine W Spurlin MD PSC
• Bijaya Ghimire, M.D.
• Michelle Dooley Ghimire
• Margaret S Gibson, LCSW
• Shayla Makell Gibson
• Zahrea Chantel Gill
• John Paul Gillespie, MD
• Cameron Gilliam

• All providers in Richmond, KY
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.